title: Incentives for healthy behaviors: experience from Florida Medicaid's Enhanced Benefit Rewards program.
abstract: OBJECTIVE
  Engaging individuals in their own health care proves challenging for policy makers, health plans, and providers. Florida Medicaid introduced the Enhanced Benefits Rewards (EBR) program in 2006, providing financial incentives as rewards to beneficiaries who engage in health care seeking and healthy behaviors.
  
  
  METHODS
  This study analyzed beneficiary survey data from 2009 to determine predictors associated with awareness of and participation in the EBR program.
  
  
  RESULTS
  Non-English speakers, those in a racial and ethnic minority group, those with less than a high school education, and those with limited or no connection to a health care provider were associated with lower awareness of the program. Among those aware of the program, these factors were also associated with reduced likelihood of engaging in the program. Individuals in fair or poor health were also less likely to engage in an approved behavior. Individuals who speak Spanish at home and those without a high school diploma were more likely than other groups to spend their earned program credits.
  
  
  CONCLUSIONS
  Findings underscore the fact that initial engagement in such a program can prove challenging as different groups are not equally likely to be aware of or participate in an approved activity or redeem a credit. Physicians may play important roles in encouraging participation in programs to incentivize healthy behaviors.
authors.affiliation: Department of Health Services Research, Management, and Policy, University of Florida, Gainesville, FL 32610, USA. hallag@phhp.ufl.edu
authors.forename: Allyson G
authors.initials: AG
authors.lastname: Hall
authors.forename: Christy Harris
authors.initials: CH
authors.lastname: Lemak
authors.forename: Amy Yarbrough
authors.initials: AY
authors.lastname: Landry
authors.forename: R Paul
authors.initials: RP
authors.lastname: Duncan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005380:Financing, Government / Q000331:legislation & jurisprudence; D005431:Florida; D015438:Health Behavior / Q000208:ethnology*; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology*; D006293:Health Promotion / Q000191:economics* / Q000331:legislation & jurisprudence / Q000379:methods; D006304:Health Status; D006801:Humans; D007342:Insurance Benefits / Q000191:economics / Q000331:legislation & jurisprudence; D008484:Medicaid / Q000191:economics* / Q000331:legislation & jurisprudence; D008875:Middle Aged; D054525:Minority Health / Q000191:economics* / Q000639:trends; D009042:Motivation; D010290:Parents; D058991:Patient Protection and Affordable Care Act / Q000191:economics / Q000592:standards; D011314:Preventive Health Services / Q000191:economics* / Q000331:legislation & jurisprudence; D012201:Reward; D014481:United States; D055815:Young Adult
keywords: Medicaid; healthy behaviors; incentives; socioeconomic factors